Identifying and treating cognitive impairment in fibromyalgia and chronic widespread pain: an epidemiological study and a feasibility study
Award Number
NIHR301808Award Type
Doctoral FellowshipProgramme
NIHR FellowshipsStatus / Stage
ActiveDates
1 January 2022 -31 December 2024
Duration (calculated)
02 years 11 monthsFunder(s)
NIHRFunding Amount
£433,019.00Funder/Grant study page
NIHRContracted Centre
University of OxfordPrincipal Investigator
Dr Eoin KelleherPI Contact
eoin.kelleher@ndcn.ox.ac.ukPI ORCID
0000-0003-2025-5556WHO Catergories
High quality epidemiological dataDisease Type
Cognitive ImpairmentCPEC Review Info
| Reference ID | 16 |
|---|---|
| Researcher | Reside Team |
| Published | 12/06/2023 |
Data
| Award Number | NIHR301808 |
|---|---|
| Status / Stage | Active |
| Start Date | 20220101 |
| End Date | 20241231 |
| Duration (calculated) | 02 years 11 months |
| Funder/Grant study page | NIHR |
| Contracted Centre | University of Oxford |
| Funding Amount | £433,019.00 |
Abstract
Research question: To understand the role of fibromyalgia syndrome (FMS) and chronic widespread pain (CWP) in the development of cognitive impairment, and identify methods to treat cognitive impairment in these patients.BackgroundFMS and CWP are common conditions, characterised by widespread pain of unknown aetiology, and affect 5% and 14% of UK adults respectively. These patients commonly report difficulty concentrating and memory impairment, typically referred to as ‘fibro-fog’. FMS and CWP are associated with impaired performance on objective cognitive tests, although it is uncertain whether there cognitive impairment is global or limited to specific domains. The role of depression and sleep impairment in the development of cognitive symptoms is also uncertain. The long-term cognitive consequences are also unclear, and whether there is an increased risk of dementia. These patients also display alterations in brain structure and function on neuroimaging, but the role of these changes in the development of cognitive impairment is unknown. Although there are many therapies for FMS and CWP, none exist for cognitive symptoms. Psychological therapies, such as cognitive behavioural therapy (CBT), have a role in treatment of FMS, but uptake is limited. Novel digital forms of CBT may be more widely accessible, however these have not been examined before for cognitive symptoms of these disorders.Aims and objectivesTo understand the role of FMS and CWP in the development of cognitive impairment, the underlying mechanisms and mediators in their development, including sleep impairment, and the role of brain structural and functional changes. A feasibility study will establish whether it is possible to conduct a trial of digital CBT targeting sleep disturbance to alleviate cognitive symptoms in patients with FMS.MethodsThe project consists of two studies. Study 1 will use data from UK Biobank, an open-access, population-based study of >500,000 adults aged 40-69. Cross-sectional and longitudinal observational research designs will be employed to examine the association between CWP and FMS with cognitive impairment. The three cognitive endpoints examined will be cognitive performance, changes on structural and functional brain MRI, and risk of incident dementia. Mediation analysis will be performed to examine the role of sleep impairment on the association. Study 2 will be a feasibility study to establish whether it is possible to conduct a trial of digital psychological treatment targeting sleep impairment, which we believe is a mediator to alleviate cognitive symptoms in patients with FMS and CWP. Timelines for deliveryThe literature review and analysis for study 1 will be completed by month 22. Study 2 will be carried out in parallel during months 13-32. The final 6 months will be occupied by the thesis write-up.Anticipated impact and dissemination This work will inform clinical practice for the recognition and treatment of cognitive symptoms in FMS and CWP, an important cause of morbidity for these patients. By addressing these symptoms, greater engagement with other aspects of treatment for these conditions may be achieved, providing health benefits for patients, and more efficient utilisation of health service resources.
Aims
To understand the role of FMS and CWP in the development of cognitive impairment, the underlying mechanisms and mediators in their development, including sleep impairment, and the role of brain structural and functional changes. A feasibility study will establish whether it is possible to conduct a trial of digital CBT targeting sleep disturbance to alleviate cognitive symptoms in patients with FMS.MethodsThe project consists of two studies. Study 1 will use data from UK Biobank, an open-access, population-based study of >500,000 adults aged 40-69. Cross-sectional and longitudinal observational research designs will be employed to examine the association between CWP and FMS with cognitive impairment. The three cognitive endpoints examined will be cognitive performance, changes on structural and functional brain MRI, and risk of incident dementia. Mediation analysis will be performed to examine the role of sleep impairment on the association. Study 2 will be a feasibility study to establish whether it is possible to conduct a trial of digital psychological treatment targeting sleep impairment, which we believe is a mediator to alleviate cognitive symptoms in patients with FMS and CWP.